Online therapy is not new. However, the number of people worldwide using teletherapy has doubled since before the COVID-19 pandemic.
The rise in online therapy during the pandemic is understandable: mental health issues increased during a time of limited access to in-person appointments. But a 2022 study states that most patients prefer virtual formats for therapy. Online therapy programs have higher completion rates, attendance and number of treatment visits.
“Therapy is just as effective when offered virtually,” says Emanuel Maidenberg, PhD, psychologist at UCLA Health. Researchers find that seeing a therapist virtually works just as well as face-to-face sessions for most people with anxiety, depression and post-traumatic stress disorder (PTSD). “Most of the therapy I provide is virtual since the pandemic. I cannot think of any instances where therapy didn’t work because it was online.”
Online therapy provides the mental health support you may need in the comfort of your home. But that doesn’t mean it’s right for everyone. Dr. Maidenberg shares what you need to know to determine if online therapy is a good option for you:
Most online therapy is cognitive behavioral therapy (CBT)
Some forms of therapy are better suited for an online format than others. Cognitive behavioral therapy (CBT), which focuses on helping people help themselves, is ideal for teletherapy.
“With CBT, we do a lot of skill training, and some of the skills work best when practiced in your natural environment,” Dr. Maidenberg says. “During a virtual session, I can see exactly what is going on and really personalize my instruction to my patient’s environment. It can have a more immediate and significant impact.”
Not everyone is a good candidate for virtual therapy
Online therapy is effective for mental health conditions that may interfere in limited ways with your daily life, such as mild or moderate forms of:
- Anxiety
- Depression
- Obsessive-compulsive disorder (OCD)
If you have more serious mental health issues or severe symptoms that substantially interfere with your ability to function, online therapy is still more effective than no therapy or treatment. But whenever possible, Dr. Maidenberg says people with more severe conditions should opt for face-to-face sessions with a therapist. It can provide more opportunities for in-person intervention and a quick, effective response in the event of a mental health crisis.
There are different options available for online counseling
There are several ways to participate in therapy online, including:
- Traditional therapy: You’ll have hour-long sessions with a licensed therapist and limited or no contact between meetings. Most health insurance pays for this type of therapy - look for traditional providers who also provide online therapy.
- Therapy apps: These mental health services follow a subscription model. Once you subscribe, they match you to a therapist for regular therapy sessions. You’ll also have 24/7 access to therapy, but communication outside of your sessions may be through text messages and not always with the same therapist.
- Other resources: Other methods of mental health support online include support groups, mental health apps and self-help resources that outline coping skills.
“One advantage to choosing traditional therapy online is that you can have an initial in-person consultation and then move to virtual sessions,” Dr. Maidenberg says. “For some people, meeting their therapist face-to-face helps establish a level of trust that is fundamental to the process.”
Benefits of online therapy
CBT in any format can work to relieve the symptoms of anxiety and depression. But online therapy can make it easier for some people to get and continue therapy for mental health issues. Dr. Maidenberg says that online therapy can offer:
- Accessibility, for people with physical impairments
- Comfort, if you have social anxiety and prefer to be alone in the comfort of your home
- Convenience, since you can schedule sessions any time, from any location
- Financial savings on transportation costs such as gas and parking
- Privacy, since you won’t see people in a waiting room
Concerns associated with online CBT
You’ll need to consider some drawbacks to online therapy when deciding if it’s right for you. Virtual therapy issues you should consider include:
- Cybersecurity, regarding your health and financial information
- Insurance coverage, which may or may not include online therapy depending on your specific coverage, where you live and which type of online counseling you choose
- Limited intervention ability, making online therapy most beneficial for people with mild-to-moderate conditions
- Missed body language cues, which can help therapists assess your mental health
- Technical issues, such as computer malfunctions or internet outages
- Therapist qualifications, as it is harder to enforce legal and ethical codes for online therapists
“Distraction can also be an issue with online therapy,” Dr. Maidenberg says. “Many things can compete for your attention at home. Make sure you have a place where you can focus on the session.”
Tips for finding an online therapist
Finding an online therapist may take a little trial and error. But there are some steps you can take for a more successful search:
- Talk to your doctor: Your primary care physician (PCP) knows your health history, understands your demeanor and likely hears feedback from other patients who use virtual therapy.
- Check your insurance directory: Insurance providers typically offer a directory of licensed mental health providers and may indicate which ones do online therapy.
- Ask a friend: Chances are good that someone you know engages in online therapy. If you feel comfortable, ask a close friend or two if they can recommend someone.
- Find an online therapy platform you trust: Most online services ask questions to narrow down your search and match you with a therapist.
Be sure to ask questions and read any reviews available for each therapist or online service. Once you find an online therapist you feel comfortable with, learn how to get the most from an online therapy session.
“Whenever you start therapy, give it four or five weeks to evaluate whether it’s a match,” Dr. Maidenberg says. “If you feel it’s not going well, talk to your therapist about it and, if needed, look for someone else. The most important thing is to find a therapist and platform that works for you.”
